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General NPI Number Information
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NPI Number | 1114781150
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Entity Type | Organization
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Legal Business Name | SMILE ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 55 WEST ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-5651
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Country | US
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Telephone | 978-534-0173
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Fax | 978-534-1130
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Provider Business Mailing Address
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Address Line | 55 WEST ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-5651
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Country | US
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Telephone | 978-534-0173
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Fax | 978-534-1130
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Authorized Official
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Title or Position | OWNER
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Name | DR. GRANIT MORINA
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Credential | DMD, MSD
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Telephone | 857-200-8323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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